Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including distal protection when performed; each additional branch subtended by the bypass graft (list separately in addition to code for primary procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,633.00 | $6,827.70 | $18,652.00 | |
Aetna
| Professional | $3,226.00 | $3,991.00 | $18,652.00 | |
Anthem BCBS
| Facility | $35,411.00 | $46,725.00 | $50,621.00 | |
Anthem BCBS
| Professional | $0.02 | $0.02 | $8.01 | |
Cigna
| Facility | $8,495.00 | $14,985.00 | $40,100.00 | |
United
| Facility | $296.00 | $1,260.00 | $36,037.00 |